Provider Demographics
NPI:1851704126
Name:MILLARD-GARCIA, ASHLEY NICOLE (MD)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:NICOLE
Last Name:MILLARD-GARCIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:NICOLE
Other - Last Name:MILLARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1630 SHERMAN AVE
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-3711
Mailing Address - Country:US
Mailing Address - Phone:847-535-6464
Mailing Address - Fax:224-271-4870
Practice Address - Street 1:1630 SHERMAN AVE
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-3711
Practice Address - Country:US
Practice Address - Phone:847-535-6464
Practice Address - Fax:224-271-4870
Is Sole Proprietor?:No
Enumeration Date:2014-06-04
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI65958 - 20207N00000X
IL036.158742207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology